Surgical management of cricopharyngeal dysphagia in dogs: 14 cases (1989–2001)

Jennifer J. Warnock Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.
Present address is Gulf Coast Veterinary Specialists, 1111 W Loop South, Ste 160, Houston, TX 77027.

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Stanley L. Marks Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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 BVSc, PhD, DACVIM, DACVN
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Rachel Pollard Department of Surgery and Radiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Andrew E. Kyles Department of Surgery and Radiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Autumn Davidson Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Abstract

Objective—To determine outcome of and complications associated with cricopharyngeal myotomy or myectomy for treatment of cricopharyngeal dysphagia (CPD) in dogs

Design—Retrospective study.

Animals—14 dogs.

Procedure—Medical records of dogs with CPD that underwent cricopharyngeal myotomy or myectomy were examined. Follow-up information was obtained through telephone interviews with owners and referring veterinarians and clinical examinations when feasible.

Results—16 surgical procedures were performed on the 14 dogs. Dysphagia was completely resolved immediately after surgery in 1 dog, and clinical signs did not recur (follow-up time of 8 years); a second dog also had immediate complete resolution of dysphagia, but follow-up time was only 10 days. Three dogs had transient complete resolution with a mean time to recurrence of dysphagia of 12.3 weeks (range, 2 to 36 weeks). Three dogs had permanent partial resolution. Six dogs had no improvement after surgery. Eight of the 14 dogs were euthanatized because of problems related to CPD, including persistent dysphagia (n = 8) and aspiration pneumonia (5).

Conclusions and Clinical Relevance—The failure rate for dogs undergoing surgical treatment of CPD may be high, particularly if concurrent aspiration pneumonia or malnutrition is not addressed prior to surgery. For those dogs with concurrent diseases, more aggressive medical management, such as enteral tube feeding, may be warranted rather than surgery. In dogs with CPD complicated by other anatomic or functional conditions, such as myasthenia gravis, laryngeal paralysis, and esophageal stricture, surgery may also not be indicated. (J Am Vet Med Assoc 2003;223:1462–1468)

Abstract

Objective—To determine outcome of and complications associated with cricopharyngeal myotomy or myectomy for treatment of cricopharyngeal dysphagia (CPD) in dogs

Design—Retrospective study.

Animals—14 dogs.

Procedure—Medical records of dogs with CPD that underwent cricopharyngeal myotomy or myectomy were examined. Follow-up information was obtained through telephone interviews with owners and referring veterinarians and clinical examinations when feasible.

Results—16 surgical procedures were performed on the 14 dogs. Dysphagia was completely resolved immediately after surgery in 1 dog, and clinical signs did not recur (follow-up time of 8 years); a second dog also had immediate complete resolution of dysphagia, but follow-up time was only 10 days. Three dogs had transient complete resolution with a mean time to recurrence of dysphagia of 12.3 weeks (range, 2 to 36 weeks). Three dogs had permanent partial resolution. Six dogs had no improvement after surgery. Eight of the 14 dogs were euthanatized because of problems related to CPD, including persistent dysphagia (n = 8) and aspiration pneumonia (5).

Conclusions and Clinical Relevance—The failure rate for dogs undergoing surgical treatment of CPD may be high, particularly if concurrent aspiration pneumonia or malnutrition is not addressed prior to surgery. For those dogs with concurrent diseases, more aggressive medical management, such as enteral tube feeding, may be warranted rather than surgery. In dogs with CPD complicated by other anatomic or functional conditions, such as myasthenia gravis, laryngeal paralysis, and esophageal stricture, surgery may also not be indicated. (J Am Vet Med Assoc 2003;223:1462–1468)

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